Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey

Abstract

Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households in Hong Kong, using random methods, and a structured questionnaire developed to survey participants. Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour. Nearly half the sample (48%) had never had a cervical smear test. Multivariable analyses showed that age, educational level, marital status, family history of cancer, smoking status, use of complementary therapy, recommendation from health professionals, and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour. Misconceptions concerned with menopause may reduce women’s perceived susceptibility to cervical cancer, especially if they are 50 or above, and exert a negative effect on their screening behaviour. Healthcare professionals should actively approach these high-risk groups–older unmarried women, smokers, those less educated and who are generally not much concerned with their health.

Place of residence and age as variables differentiating health behaviours and perception of health by women past menopause

“…It should be stressed that the majority of women living in rural areas were those who assessed their own health as very good and good (64.8%). The findings in this scope in the current study are different from results of a survey among 959 Chinese women aged 50 or above, in which the majority perceived their health status as "fair" or "poor" (62%) [21].…”

“…It is important for women to be aware that the quality of their life in the fifth and subsequent decades depends on how much care of health they take. This is also highlighted in other studies [21,40,44].…”

“…A study by Skórzyńska et al [24] among 150 women over 50 years of age revealed that they did not perform cytology or mammography more regularly (61.3% of the surveyed women had undergone cytology and 51.3% mammography in the last 2 years), and medical recommendations regarding early detection of cancers were frequently ignored by them. The results from the study among Chinese women at the same age were even worse: half of surveyed women (52.1%) had never had a cytology, and 66% of them thought that this test was not necessary after menopause [21].…”

Protection motivation theory in predicting intention to receive cervical cancer screening in rural Chinese women

“…This finding suggests that PMT‐based intervention programs may benefit by considering these factors. A study reported that Chinese women may have misconceptions about the risk of cervical cancer at more advanced ages, undermining the motivation to undergo cervical screening even though they are still at risk of the disease . Also, higher annual income levels may promote women's cervical screening intention by utilizing medical service conveniently and improving their health literacy in understanding cervical cancer‐related knowledge, including signs and symptoms.…”

Perception of health, health behaviours and the use of prophylactic examinations in postmenopausal women

“…The results of the present study indicate that prevailing prohealth activities encompass prophylactic behaviours. Postmenopausal women should be under a regular care of a gynaecological clinic, just like younger women, and the frequency and type of appointments should be agreed individually, depending on the needs [46]. Nevertheless, gynaecological check-ups should take place at least once a year [14].…”